Ashok Kumar, M (2017) A Comparative study of Subcutaneous Suction Drainage Tube with Conventional Primary Skin Closure following Abdominal Surgeries, in case of Peritonitis. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Surgical Site Infection and delayed wound failure are reported more commonly in abdominal surgeries performed in cases of peritonitis than in other gastrointestinal surgeries. Post operative Surgical Site Infection (SSI) is a significant cause of morbidity in terms of prolonged hospital stay and increased expenses. Though pre-operative antibiotic prophylaxis and per operative thorough peritoneal lavage play a major role in preventing SSI, an effective method of closure of wound is also important. Burst abdomen following wound dehiscence in SSI is a major concern for surgeons as it can cause compromise of respiratory functions if reclosure is done, whereas, nosocomial infection can occur if the wound is left open. Subcutaneous negative suction drainage has been shown to reduce the incidence of SSI and wound dehiscence by causing drainage of the infective material and promoting wound healing. This study was done to compare the effectiveness of sub-cutaneous negative suction drainage tube and conventional abdominal wall closure in cases of peritonitis with regard to SSI, wound dehiscence, wound secondary suturing and duration of hospital stay. AIM OF THE STUDY: To compare and find out the effective method of abdominal wall closure in cases of peritonitis between subcutaneous suction drainage tube and conventional primary skin closure. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: 60 patients who presented at the emergency department with acute abdominal pain and operated for the same, with features s/o peritonitis were enrolled into the study. 30 of them were managed with subcutaneous negative suction drainage tube during abdominal wall closure (Group A). 30 other patients underwent conventional method of abdominal wall closure (Group B). On table pus c/s was sent for all 60 cases. The surgical wound was observed for signs of infection. Any sero-purulent collection from the drain or any discharge from the wound was sent for c/s and the results of which were compared with the results of on table pus c/s. If wound dehiscence was noted, secondary suturing was done after the wound healed. The duration of suction drain placement and stay in the hospital were noted in all cases. STATISTICAL ANALYSIS: The results were analyzed with Chi-square test and Student t test (unpaired) and p values were calculated. A p value of less than 0.05 was considered significant. RESULTS: The incidence of SSI was significantly less in Group A (23%) than in Group B (60%). Similarly, wound dehiscence occurred in 43% of SSI cases in Group A as against 89% of SSI cases in Group B, the difference of which was statistically significant. The mean duration of hospital stay was significantly less when subcutaneous suction drain was placed (9 days). CONCLUSION: Subcutaneous suction drainage tube is an effective method of abdominal wall closure in cases of peritonitis when compared to conventional primary skin closure as it significantly reduces the incidence of SSI, wound dehiscence, wound secondary suturing and duration of hospital stay.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Subcutaneous Suction Drainage Tube, Conventional Primary Skin Closure, Abdominal Surgeries, Peritonitis. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 18 Mar 2020 03:43 |
| Last Modified: | 18 Mar 2020 07:06 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12325 |
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